Lymphatics Lecture Flashcards
1
Q
lymphatic system is known as…
A
-second circulatory system of the body and the great integrator for all body fluids
2
Q
what is the lymphatic system a conduit to?
A
- immune system
- it is a passive system
3
Q
what can alter the lymphatic system?
A
- extrinsic forces
- examples: OMT, exercise, nutrition, sleep, normal day to day movement
4
Q
what are the roles of the lymphatic system?
A
- homeostasis
- transports fat from digestive system to blood
- facilitates immune function
- vital role in overall circulatory system
- assists the body in removing intestinal fluids and plasma proteins
5
Q
development of lymphatic system
A
- begins development at 5th week gestation and significantly present by 20 weeks gestation
- immature at birth
- matures and undergoes change until puberty, when stable adult levels of lymphoid tissue remain
- lymphatics decline in fcn in geriatric population
6
Q
components of lymphatic system
A
- organized lymph tissue
- lymph channels/collecting ducts
- lymph fluid
7
Q
where is the spleen located and what are its functions?
A
- beneath ribs 9, 10, 11 on left between heme-diaphragm and peritoneal cavity
- movement of diaphragm is important for homeostatic movement of splenic fluids
- destroys damaged RBCs
- synthesizes Igs
- clearance site for Ags, micro-organisms, poorly organized bacteria
8
Q
what is the function of the liver?
A
- forms half of body’s lymph
- “gate keeper” of shared hepato-biliary-pancreatic venous and lymphatic region
- clear bacteria
9
Q
where is the thymus and what is its function?
A
- superior mediastinum, anterior to great vessels, extends to neck
- large in infant
- –after puberty–involutes
- –adult–replaced by fatty tissue
- provide cells involved in maturation of immune system
- processing site for T-lymphocytes
- little or no fcn in adult
10
Q
what are the 3 types of tonsils and the functions?
A
- palatine–lateral pharynx
- lingual–posterior 1/3 of tongue
- pharyngeal–adenoids at nasopharyngeal border
- provide cells to influence and build immunity early in life
- nonessential to adult immune fcn
11
Q
where is the appendix and what is its fcn?
A
- medial surface of cecum
- presume it offers support to immune system
12
Q
what is visceral lymphoid tissue used for in the respiratory system?
A
-aids filtration of toxins from lungs
13
Q
what is visceral lymphoid tissue used for in the GI system?
A
- peyer’s patches–distal ilium
- lacteals–lymphatic capillaries in each villi in small bowel
- fats enter circulation via GI system
14
Q
where are lymph nodes and what is the purpose?
A
- dispersed along course of lymph vessels
- for filtration of lymph
15
Q
what are the 2 types of lymph nodes?
A
- superficial–follows subcutaneously with superficial veins
- deep–beneath fascia and muscles, follows deep veins
16
Q
where do superficial lymph nodes receive lymph and drain into?
A
- receive from skin/deep tissue of upper and lower extremities/head and neck
- drain into 3 main groups of nodes:
1. cervical
2. axillary
3. inguinal
17
Q
what do lymph channels not perfuse?
A
- CNS (some research says there are lymph vessels now!)
- epidermis (and hair/nails_
- endomysium of muscles and cartilage
- bone marrow
- parts of peripheral nerves
18
Q
what is the structure of the lymph system?
A
- unidirectional fluid flow in channels
- flow controlled by one way valves
- channels/nodes surround major organs and vessels
- unite with thoracic duct or right lymphatic duct
19
Q
where is Virchow’s node and what is it associated with?
A
- left supraclavicular region
- associated with intra-abdominal or thoracic carcinoma/cancer
20
Q
right and left lymph drainage of the body
A
- right–right side of head, right arm, right torso
- left–left side of head, left arm, left torso, left/right legs
21
Q
where is the thoracic duct?
A
- lies against vertebral column between aorta and azygous vein
- at level of T4 moves left of midline and connects to junction of left subclavian and left brachiocephalic veins
22
Q
what does the thoracic duct drain?
A
- left side of head and neck
- left arm
- left side of thorax
- left/right side of lower body
- viscera of thoracic
23
Q
what is the origin of the thoracic duct?
A
- cisterna chyli
- anterior to L1-2 and posterior to right crura of diaphragm
24
Q
what does the right lymphatic duct drain and connect?
A
DRAINS:
- right head and neck
- right arm
- right chest
CONNECTS:
-venous system at jugular subclavian junction
25
what is lymph fluid and what are the components of lymph fluid?
- substance tha leaks out of arterial capillaries into the interstitial and into single cell lymphatic vessels
- components:
- -proteins
- -salts
- -fats
- -lymphocytes
- -clotting factors
- -large particles: bacteria and viruses
26
what are the functions of the lymphatic system?
- fluid balance
- purification and cleansing
- defense
- nutrition
27
explain fluid balance of the lymphatic system
- 50% of plasma proteins re-enter system via lymph
- can absorb some excess fluid from plea, peritoneum, pericardium, and joints
- large proteins can enter lymphatic system
- aids in homeostasis
28
explain purification and cleansing of the lymphatic system
- lymph fluid bathes all organs
- cleanses extracellular spaces of particulate matter, exudate, and bacteria
- fluid is delivered to the node
29
explain defense and the lymphatic system
- brings toxins, bacteria, viruses into contact with lymphatic system--acquired immunity
- free flowing of lymph necessary for good immune fcn
30
explain nutrition and lymphatic system
- lymph returns proteins back to vascular system
- proteins bind to nutrients
- fats absorbed via lymph system
31
mechanisms of lymph flow
- interstitial fluid pressure
| - intrinsic/extrinsic lymphatic pump
32
what is normal interstitial fluid pressure?
- 6.3 mmHg
- increase in pressure will increase flow
- above 0 mmHg vessels will collapse and obstruct flow
33
how to increase interstitial fluid pressure?
- increased arterial capillary pressure
- decreased plasma colloidal osmotic pressure (hepatic cirrhosis)
- increased interstitial fluid protein (starvation)
- increased capillary permeability
34
explain the intrinsic pump
- distension of larger vessels trigger construction of smooth muscle and pumps fluid to next segment
- smaller vessels: endothelial cells have contractile fibers that respond to dissension
- contraction causes pressure gradients to help move fluid
35
explain extrinsic pump
- direct pressure on vessels moves lymph
- internally anywhere pressure exerted will increase flow
- thoracic diaphragm:
- --crura acting on cisterns chill
- --respiration produces pressure gradients b/w thorax and abdomen
- --pressure gradients and one way valves pull lymph toward lymph circulation
36
when is the pelvis diaphragm important in the extrinsic pump?
- synchronous with abdominal diaphragm
- movement of interstitial fluids from pelvis
- important in: dysmenorrhea, prep for labor/delivery, prostate irritation
37
what are the results of poorly functioning lymphatic system?
- edema: build up of interstitial fluid
- result of too much fluid in interstitial and too little fluid flowing out of interstitium
- increase of interstitial pressure causes collapse of lymph capillaries
38
effects of edema
- compression of lymph vessels and neuromuscular structures
- tissue congestion
- fluid stasis changes pH of tissue/organ
- decreased delivery of nutrients
- decreased bioavailability of drugs and hormones
39
what is the goal of OMT for the lymphatic system?
balanced, well functioning lymphatic system in which no edema occurs
40
where do you start OMT of lymphatics?
thoracic inlet to release fascial restrictions that may impede lymph flow into venous sytem
41
treatment sequence of OMT for lymphatics?
- start centrally at thoracic inlet and work way out distally
- always return to treat thoracic duct
42
OMT areas of treatment for lymphatics
1. thoracic
2. abdomen
3. upper extremity
4. lower extremity
5. head and neck
43
where is submental LN?
under the chin
44
where is submandibular LN?
along mandible
45
what does thoracic duct drain?
- left side of head and neck
- left arm
- left side of thorax
- all lower body
- viscera
46
if someone has cancer, broken bone, bacterial infection, hepatitis...
contraindications--do not do OMT b/c don't want to move the infection, cancer around
**can do on a bacterial infected pt if they have had antibiotics
